Medi-Cal Utilization among Foster Children: Evaluating Recent California Policy Initiatives


Jeff Geppert, Grecia Marrufo, and Dana Rapoport
April, 2004

Recognizing that the medical needs of foster children are often unmet, the California legislature passed three reforms during the last four years to improve the delivery of health care services to these children. First, the Health Care Program for Children in Foster Care (HCPCFC) increases the use of public health nurses to promote comprehensive preventive and specialty health services for children in foster care. Second, the Kinship Guardianship Assistance Payment program (Kin-GAP) promotes the permanency of living arrangements by providing financial aid to relatives who become the legal guardians of children in the foster care system. Lastly, Medi-Cal benefits were automatically extended to former foster children 18 to 20 years of age. In this report, we examine the effects of these reforms on the circumstances of foster children. In particular, we examine their use of Medi-Cal services to meet their physical and mental health needs. On the whole, we find that recent legislative changes have had a positive impact on the Medi-Cal experiences of the target populations. Both HCPCFC and Kin-GAP appear to have increased the prevalence of preventive care in the form of well-being visits. Further, former foster children (18 to 20 years of age) were less likely to use emergency services after the Medi-Cal age extension than they were before the reform. These findings are useful for evaluating the current reforms and will inform future policy developments; however, because our examination addresses only the first year of the programs’ implementations, our findings may underestimate the ultimate results. Long-term studies of these reforms may reveal further improvements in health care delivery for children in foster care.